| Organization Name: | SPINEZONE MEDICAL FITNESS |
| NPI Number: | 1245638485 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FRANK GRANT (COO) |
| Mailing Address: | 8851 Center Drive Suite 201 La Mesa |
| State: | CA US |
| Postal Code: | 91942 |
| Phone Number: | 6196441770 |
| Fax Number: | 8668131235 |
| NPI Enumeration Date: | 12/19/2014 |
| NPI Last Update Date: | 12/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |